Perioperative Quiz

which actions will the nurse take when 100 mL of blood is noted in the drainage system for a client who has just returned to the nursing unit after a radical neck dissection? (select all the apply) 1. notify the health care provider 2. elevate the lower extremities 3. obtain pulse and blood pressure 4. suction the client's tracheostomy 5. remove dressings and check incision

1, 3

after undergoing minor surgery, a postoperative child has recovered from anesthesia. which observations alert the nurse the child may be ready for discharge? 1. vital signs are stable 2. temperature is 101 F 3. pain rate is at baseline level 4. the child is alert and oriented 5. oxygen saturation is 75% on room air

1, 3, 4

a client is scheduled for gastrointestinal surgery. which is the most important nursing action that would be implemented the evening before surgery? 1. reviewing the client's pain history 2. ensuring the client's bowel preparation is initiated 3. discussing the importance of postoperative activity restrictions 4. reviewing postoperative comfort measure strategies

2

which items would the nurse include in assessment of the integumentary system for a preoperative client? (select all that apply) 1. inspect the neck for distended veins 2. assess the skin turgor for signs of dehydration 3. examine the skin for rashes or lesions 4. question the client about any skin disorders 5. palpate the chest for heaves or lifts

2, 3, 4

which preoperative actions would the nurse plan when caring for a client scheduled for a septoplasty? (select all that apply) 1. teach the client how to use hot compresses 2. encourage the client to quit smoking before surgery 3. observe the surgical site for edema 4. teach the client about post surgery activities that are restricted 5. assess the client's respiratory status 6. encourage the client to take aspirin before the surgery

2, 3, 4, 5

a client with a history of recurrent cholecystitis is scheduled for an abdominal cholecystectomy. which would the nurse specifically emphasize when planning preoperative teaching for this client? 1. possible complications 2. food and fluid restrictions 3. coughing and deep breathing 4. isometric exercises of the extremities

3

the nurse understands which group of the pediatric population is at a higher risk of developing respiratory complications upon administration of general anesthesia? 1. infants 2. children 3. neonates 4. adolescents

3

a child's blood test after receiving a general anesthetic indicates increased intracellular calcium levels. which medication would the nurse anticipate administering to this client? 1. aspirin 2. naproxen 3. ibuprofen 4. dantrolene

4

a health care team is caring for a client with dental pain. which task can be delegated to unlicensed assistive personnel (UAP) to provide effective client care? 1. administering analgesics 2. administering intravenous antibiotics 3. administering nerve block anesthesia 4. administering mouthwash for oral hygiene

4

nursing actions after a client has had general anesthesia are directed at preventing which postoperative respiratory complication? 1. pleural effusion 2. empyema 3. pneumothorax 4. atelectasis

4

a postoperative client says to the nurse, "the person in the next room sings all night and keeps me awake." the client in the next room has dementia and is awaiting transfer to a. nursing home. how can the nurse handle this situation? 1. tell the next door client to stop singing 2. close the doors to both clients' rooms at night 3. give the complaining client the prescribed as-needed sedative 4. move the postoperative client to a room at the end of the hall

4.

which technique would the nurse use to maintain surgical asepsis? 1. change the sterile field after sterile water is spilled on it 2. put on sterile gloves before opening a container of sterile saline 3. place a sterile dressing no more than half an inch from the edge of the sterile field 4. clean the surgical area with a circular motion, moving from the outer edge toward the center

1

the nurse is caring for a client who has just received epidural anesthesia. the nurse would monitor for which adverse effects? 1. uterine atony 2. hypotension 3. decreased urine production 4. precipitous second stage of labor

2

which statement by the nurse regarding anesthetic drugs in pediatric clients requires correction? 1. "pediatric clients are more affected by anesthesia than adults" 2. "during general anesthesia, the upper airway obstruction risk is less in pediatrics" 3. cardiac abnormalities are more common in pediatric clients receiving anesthesia" 4. "the central nervous system of pediatric clients is more sensitive to the effects of anesthetics"

2

which finding on the first postoperative day after a client has an open reduction and internal fixation of a fractured hip will be most important to report to the health care provider? 1. client report of level 8 incisions pain (0 to 10 scale) 2. 50 mL of deep red drainage in wound drainage device 3. swelling and redness in the calf of the operative leg 4. client oral temperature elevation to 100.2 F

3

which action would the nurse take first after noting stridor in a client who just arrived in the post anesthesia care unit (PACU) after receiving a general anesthetic? 1. have the client cough 2. check respiratory rate 3. auscultate breath sounds 4. notify the health care provider

4

the nurse notes a client's BP of 200/110 mm Hg and swelling of the operative leg after femoropopliteal bypass graft. which action would the nurse take next? 1. evaluate the client's orientation 2. check pedal pulses distal to the graft 3. notify the client's health care provider 4. monitor blood pressure every 15 minutes

3

as a part of an informed consent, a surgeon explains the details of the surgery and related care to the client. the nurse leader witnesses the compete process. the nurse leader would ensure the surgeon provided which information to the client? (select all the apply) 1. surgical procedure 2. name of the surgeon 3. explanation of the possible risks 4. anesthetic medication used during preoperation 5. name of the staff members who will be in the surgery

1, 2, 3

the nurse is caring for an infant who is to undergo surgery for hypertrophic pyloric stenosis (HPS). which clinical scenario would the nurse recognize as important for surgical success? 1. vomiting is not yet severe and projectile 2. fluid and electrolyte imbalances are corrected 3. small feedings of thickened formula are tolerated 4. amount of drainage from gastric decompression is sufficient

2

a female client is scheduled for a hysterectomy. while discussing the preoperative preparations, the nurse determines that the client's understanding of the surgery is inadequate. which nursing intervention would be performed? 1. describing the proposed surgery to the client 2. proceeding with the preoperative plan 3. notifying the surgeon that the client needs more information 4. explaining gently to the client that she should have asked more questions

3

which action is the priority when the preoperative nurse learned that a client is taking several herbal supplements? 1. provide the client with information about the usefullness of herbal therapies 2. inform the client about taking supplemental vitamins rather then herbs 3. teach the client about herbal supplements 4. ask the client which herbs have been taken

4

a client is likely to undergo reconstructive surgery for which purpose? 1. to restore function and/or appearacne 2. to replace an organ or tissues to relive or reduce symptoms 4. to remove or excise an organ or tissue

1

a client is transferred to an acute care cursing unit after surgery. which action of the nurse is most important and would be performed first? 1. assess the patency of airway 2. ask if the client is comfortable 3. determine the level of consciousness 4. review the order for intravenous fluids

1

a client who was admitted to the hospital with metastatic cancer has a temperature of 100.4 F, a distended abdomen, and abdominal pain. the client asks the nurse, "do you think that I will need to have surgery?" how would the nurse respond? 1. "you seem concerned about having surgery" 2. "some people with your problem do have surgery" 3. "ill find out for you. your record will show if surgery is scheduled" 4. "I don't know about any surgery. you'll have to ask your health care provider"

1

after an acute episode of upper gastrointestinal (GI) bleeding, a client vomits undigested medications and reports severe epigastric and abdominal pain. The client has absent bowel sounds, rigid abdomen, a pulse rate of 134, and shallow respirations of 32 per minute. the primary health care provider has been contacted. which action would the nurse take next? 1. keep the client nothing by mouth (NPO) 2. teach the client about coughing and deep-breathing exercises 3. inquire whether any red or black stools have been noted 4. place the client in the supine position with the legs elevated

1

which priority intervention would the nurse follow when caring for a client with malignant hyperthermia? (select all that apply) 1. administer 100% oxygen 2. prepare for endotracheal intubation 3. monitor the core body temperature 4. stop all inhalation anesthetic agents 5. insert an indwelling urinary catheter

1, 2, 4

which action would the circulating nurse classify as a priority during surgery? (select all that apply) 1. protecting client's privacy 2. assessing blood loss and urine 3. monitoring ventilation for nonintubated clients 4. monitoring the level of anesthesia provided to the client 5. providing supplies and equipment on the basis of the surgical team's needs

1, 2, 5

which action by na unlicensed assistive personnel (UAP) who is assisting with the care of a client who just returned to the nursing unit after laryngoscopy indicates that the nurse needs to intervene? 1. raises the head of the client's bed 2. offers a breakfast tray to the client 3. asks whether the client's throat is painful 4. checks the client's oxygen saturation using pulse oximetry

2

which nursing assessment is a priority after a client undergoes an endarterectomy in a lower extremity? 1. appetite 2. skin color 3. bowel habits 4. tissue turgor

2

whiten how many hours after a surgical procedure requiring general anesthesia would the nurse expect a client to void? 1. 4 hours 2. 8 hours 3. 10 hours 4. 12 hours

2

which action would the nurse take to properly prepare the site for insertion when assessing a client's forearm for a potential intravenous (IV) catheter insertion site reveals an excessive amount of hair? 1. clip the hair 2. have the area 3. apply a securement device 4. prepare the skin with a protectant solution

1

which client statement would cause the nurse to stop the health care provider from initiating epidural anesthesia? 1. "im not exactly sure how an epidural works" 2. "I understand that the epidural might or might not take my pain away" 3. "I signed the consent form for an epidural at my last clinic appointment" 4. "I'm aware that the epidural could cause my contractions to slow down"

1

a client who wakes up after surgery spits out the oral airway placed during the recovery form anesthesia. what would this behavior indicate to the nurse? 1. their gag reflex has returned 2. they are confused due to anesthesia 3. they are nauseated and want to vomit 4. their airway is becoming obstructed

1

the nurse finds that the surgical mask being worn has become moist before going into surgery. which would the nurse do? 1. dispose of the mask and put on a new one 2. wait until the mask gets dry and then enter the operating room 3. do not cough or sneeze while wearing the mask 4. talk less after wearing the mask to minimize respiratory airflow

1

when performing a client's postoperative assessment, which parameter would alert the nurse to a common side effect of epidural anesthesia? 1. decreased blood pressure 2. increased oral temperature 3. diminished peripheral pulses 4. unequal bilateral breast sounds

1

a client newly diagnosed with cancer of the pancreas is scheduled from surgery. the client asks the nurse, "don't you think that some other treatment would be better than surgery?" how would the nurse respond? 1. "its a good idea to explore other acceptable treatments for your career. there's is information available for you" 2. "surgery is the recommended approach. perhaps you should discuss this further with the health care provider" 3. "maybe you will be more confident with a second opinion. I think you need a referral to another health care provider" 4. "with your disease, your prognosis will improve if you follow the suggestion to have the recommended surgery"

2

a complete blood count (CBC), urinalysis, and x-ray examination of the chest are prescribed for a client before surgery. the client asks why these tests are done. which reply by the nurse is best? 1. "don't worry; these tests are routine" 2. "they are done to identify other health risks" 3. "they determine whether surgery will be safe" 4. "I don't know; your health care provider prescribed them"

2

in which position would the nurse place a sedated client recovering from general anesthesia? 1. supine 2. side-lying 3. high fowler 4. trendelenburg

2

which action will the nurse anticipate needing to take when a client develops hypotension immediately after receiving spinal anesthesia? 1. increase intravenous flow rate 2. reschedule the surgical procedure 3. have the client move the extremities 4. infuse medication to increase heart rate

1

which finding for a client who has just returned to the nursing unit after a bronchoscopy and lung biopsy would be most important to report to the health care provider? 1. client arousable, but lethargic 2. cough productive of bloody mucus 3. heart rate 126 beats per minute 4. client report of dry and sore throat

3

postoperative arterial blood gas values for a client in the post anesthesia care unit are pH 7.32, PaCO2 53, HCO3 25, and PaO2 85. which action would the nurse take? 1. plan to send the client to the medical-surgical unit 2. ask the anesthesiologist to consider reintubation 3. encourage the client to take deep breaths and cough increase the oxygen flow rate from 4 to 6 L/min

3

the nurse is providing preoperative education to a client scheduled for orthopedic surgery at 8:00 am the next day. which instruction would the nurse include? 1. "have your dinner completed by 6:00 pm tonight and then no food or fluids after that" 2. "drink whatever liquids you want tonight and then only clear liquids tomorrow morning" 3. "consume a light evening meal tonight and then no food or fluids after midnight" 4. "eat lunch today and then do not drink or eat anything until after your surgery"

3

which complication would the nurse consider in a client who just had a total hip replacement and is experiencing restlessness and changes in mentation? 1. bladder spams 2. polycythemia vera 3. hypovolemic shock pulmonary hypertension

3

which response by the nurse asked "How will the 'knock me out' for this colonoscopy?" described the route of administration for conscious sedation? 1. "the medicine will be injected into your spine" 2. "you will receive the anesthesia through. face mask" 3. "you will receive medication through an intravenous (IV) catheter" 4. "we will give you an oral medication about 1 hour before the procedure"

3

which route of administration will be used to deliver conscious sedation to a client during a cardiac catheterization? 1. via a face mask 2. into the epidural space 3. through an intravenous catheter 4. around the nerves innervating the chest wall

3

the nurse would primarily focus on which concept when providing preoperative teaching? 1. helping the client and family decide if surgery is necessary 2. providing emotional support to the client and family 3. giving specific details of the surgery to the client and family 4. providing general information to reduce client and family anxiety

4

which action would the nurse plan to take to prevent aspiration in a client who has just returned to the nursing unit after bronchoscopy? 1. administer oxygen through nasal cannula 2. have the client rest in the supine position 3. suction oral secretions at frequent intervals 4. withhold food until the gag reflex returns

4

which action would the nurse take first when doing preoperative teaching for a client who is scheduled for a total laryngectomy? 1. arrange for a speech therapist visit 2. provide an explanation of the surgery 3. develop a plan for communication after surgery 4. ask what questions the client has about the procedure

4

which assessment finding would be important for the nurse to report to the health care provider when caring for a client who is in the post anesthesia care unit after receiving general anesthesia? 1. attempting to push the airway out 2. unresponsive to verbal stimulation 3. respirations at 16 breaths/min and unlabored 4. systolic blood pressure decrease from 130 mm Hg to 90 mm Hg

4

which initial action would the nurse take when obtaining consent for surgery? 1. describe the risks involved in the surgery 2. explain that obtaining the signature is routine for any surgery 3. witness the client's signature, which the nurse's signature will document 4. determine whether the client's knowledge level is sufficient to give consent

4

which is the first sign that would assist the nurse in suspecting malignant hyperthermia in a client? 1. abnormal rapid heart rate 2. abnormal rapid breathing 3. increased body temperature 4. increased expired carbon dioxide

4